Published online Apr 15, 2014. doi: 10.4251/wjgo.v6.i4.98
Revised: December 26, 2013
Accepted: February 16, 2014
Published online: April 15, 2014
AIM: To study the salient features of colorectal cancer (CRC) in Libya.
METHODS: Patients records were gathered at the primary oncology clinic in eastern Libya for the period of one calendar year (2012). Using this data, various parameters were analyzed and age-standardized incidence rates were determined using the direct method and the standard population.
RESULTS: During 2012, 174 patients were diagnosed with CRC, 51.7% (n = 90) male and 48.3% (n = 84) females. The average age was 58.7 (± 13.4) years, with men around 57.3 (± 13) years old and women usually 60.1 (± 13.8) years of age. Libya has the highest rate of CRC in North Africa, with an incidence closer to the European figures. The age-standardized rate for CRC was 17.5 and 17.2/100000 for males and females respectively. It was the second most common cancer, forming 19% of malignancies, with fluctuation in ranking and incidence in different cities/villages. Increasingly, younger ages are being afflicted and a higher proportion of patients are among the > 40 years subset. Nearly two-thirds presented at either stage III (22.4%) or IV (38.4%).
CONCLUSION: Cancer surveillance systems should be established in order to effectively monitor the situation. Likewise, screening programs are invaluable in the Libyan scenario given the predominance of sporadic cases.
Core tip: Colorectal cancer incidence in Libya has changed greatly since the last time it was determined nearly a decade ago. Libya was found to have the highest incidence rate in North Africa, with younger ages more affected. Late presentation was found to be a major problem in the Libyan case. Clear urban-rural differences were seen when the different districts were analyzed. Different hypotheses are put forth to explain these variations. Proper surveillance and screening programs need to be established and healthcare policies should be adjusted to take into account the increasing rate of this malignancy.